J Korean Ophthalmol Soc.  2018 Apr;59(4):362-368. 10.3341/jkos.2018.59.4.362.

Comparison of the Efficacy of Topical Steroids after Trabeculectomy in Patients with Primary Open-angle Glaucoma

• Ha JY
• Lee TH
• Sung MS
• Park SW

• KMID: 2409685
• DOI: http://doi.org/10.3341/jkos.2018.59.4.362

Abstract

PURPOSE
To compare the surgical outcomes and intraocular pressure (IOP) reduction after trabeculectomy in patients with primary open-angle glaucoma (POAG) according to treatment with three different postoperative topical steroids.
METHODS
A total of 84 eyes of 84 patients who had undergone trabeculectomy for POAG and were followed-up at least 1 year were included in this study. According to the postoperative topical steroid treatment, the patients were divided into three groups involving 0.5% loteprednol etabonate (LE), 1% rimexolone (RMX), and 1% prednisolone acetate (PDA). The mean IOP change, mean number of topical anti-glaucoma medication changes, 1-year success rate, and complication percentage were compared among the three groups.
RESULTS
There were significant reductions in the IOP and number of anti-glaucoma medications during the postoperative 1-year follow-up in all of the groups (all, p < 0.05), but there were no differences among the three groups. Postoperative 1-year success rates (68.2% in the LE group, 67.0% in the RMX group, and 65.9% in the PDA group; p = 0.88) and complication percentages of trabeculectomy were not significantly different among the three groups.
CONCLUSIONS
There were no statistical differences in the 1-year success rate, complication percentage, visual acuity, IOP, and number of anti-glaucoma medications among treatment regimens. LE and RMX were as effective and safe as PDA after trabeculectomy in patients with POAG.

Keyword

Primary open-angle glaucoma; Topical steroid; Trabeculectomy

MeSH Terms

Follow-Up Studies
Glaucoma, Open-Angle*
Humans
Intraocular Pressure
Loteprednol Etabonate
Prednisolone
Steroids*
Trabeculectomy*
Visual Acuity
Loteprednol Etabonate
Prednisolone
Steroids

Figure

• 

  Figure 1. The changes in best corrected visual acuity (BCVA), intraocular pressure (IOP), and mean number of anti-glaucoma medication in the three groups during the 1-year follow-up. (A) BCVA was remained stable during the follow-up in the three groups. (B, C) IOP and mean number of glaucoma medication were significantly reduced after trabeculectomy through the 1-year follow up. There were no significant differences in BCVA, IOP, or mean number of glaucoma medication among the three groups. mon = month(s); LE = loteprednol etabonate; RMX = rimexolone; PDA = prednisolone acetate.

• 

  Figure 2. Cumulative probabilities of success of trabeculectomy in the three groups. The success rates at 1 year was 68.2% in loteprednol etabonate (LE) group, 67.0% in rimexolone (RMX) group, and 65.9% in prednisolone acetate (PDA) Group, which was not significantly different among the three groups (p = 0.877, log-rank test). mon = month(s).

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